AB0918 EVALUATION OF X-RAY PROGRESSION AT 6 YEARS FOLLOW-UP OF TREAT-TO-TARGET STRATEGY IN EARLY PSORIATIC ARTHRITIS
Authors: P. Tremaskina, E. Loginova, T. Korotaeva, A. Sukhinina, S. Glukhova, A. Smirnov, A. Lila
Journal: Annals of the Rheumatic Diseases (2022)

Background In Psoriatic arthritis (PsA) patients (pts) persistence inflammation in the peripheral joins leading bone erosions, joint space narrowing and new bone formation. Tight control of PsA disease improved joint and skin outcomes, but the number of pts with erosions increased [1]. Despite of clinical improvement no long-term treat to target (T2T) strategy data on radiographs progression yet [2]. Objectives To study X-ray progression in PsA pts treated according to T2Tstrategy at the early stage of disease at 6 years (yrs) follow-up. Methods 30 (M/F–17/13) PsA pts fulfilling CASPAR criteria, mean age 44.7±11.4 yrs, median (Me) PsA duration 78.5 [66;95] month (mos), Me follow-up 71 [60;86] mos, Me DAPSA 24 [7;45]. All pts was treated according to T2T strategy at the early stage with MTX alone or in combination with iTNF within 2 yrs. When T2T study was ended all pts were treated according to standard care. All pts underwent standard clinical examination of PsA activity, DAPSA was calculated. Radiographs of the hands and feet were available for 30 pts at baseline and 26 (86.6%) at 6-yrs follow-up. Radiographs of the hands and feet were scored using the modified van der Heijde-Sharp (m-v-d-HS) scoring method for PsA assessing both erosion, joint space narrowing (JSN) and total score (TS) m-v-d-HS. Scoring was done by two readers. The number of pts with erosions was calculated at baseline and 6 yrs later. M±SD, Me [Q25; Q75], Me (Min-Max), Mann-Whitney test were performed. All p&lt;0.05 were considered to indicate statistical significance. Results At 6 yrs follow-up Me TS m-v-d-HS and JSN significantly increased from 34 (0-104) to 50 (6-253) and from 34 (0-97) to 50 (6-127) accordingly (p=0.006 and p=0.011); count of erosion from 0 (0-13) to 4 (0-128), p=0.002. In 19 out of 26 pts significantly negative X-Ray progression in the feet and hands by TS m-v-d-HS, count erosion, joint space narrowing was seen (for all p&lt;0.05). In 7 out of 26 pts no X-Ray progression was found. PsA activity by DAPSA was significantly higher in pts with X-ray progression compare to those without progression 14.1 [5.19;33.67] and 2.22 [0.55;13.54] accordingly (p=0.04). 6 yrs later the number of pts with erosions significantly increased from 12 out of 26 (46%) at baseline to 22 out of 26 (85%) pts accordingly (p=0.002). Conclusion At 6 yrs follow-up negative radiographic progressions in the hand and feet found in mostly early PsA pts despite of tight control treatment strategy within 2 yrs. References [1]Coates LC, Moverley AR, McParland L, Brown S, Navarro-Coy N, O’Dwyer JL, Meads DM, Emery P, Conaghan PG, Helliwell PS. Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet. 2015 Dec 19;386(10012):2489-98 [2]Coates LC, Mahmood F, Freeston J, Emery P, Conaghan PG, Helliwell PS. Long-term follow-up of patients in the TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) trial. Rheumatology (Oxford). 2020 Apr 1;59(4):807-810 Disclosure of Interests Polina Tremaskina: None declared, Elena Loginova Speakers bureau: Janssen, Tatiana Korotaeva Speakers bureau: Pfizer, MSD, AbbVie, Novartis-Sandoz, JSC Biocad, Janssen, UCB, Lilly, Anastasiia Sukhinina: None declared, Svetlana Glukhova: None declared, Alexander Smirnov: None declared, Alexander Lila: None declared